Condition | Characteristic clinical features |
Nasolacrimal duct obstruction | |
Simple | Increased tear meniscus; reflux of tears/mucoid discharge through puncta with palpation of lacrimal sac |
Dacryocystocele | Blueish swelling overlying the lacrimal sac; superior displacement of medial canthal tendon |
Conjunctivitis | |
Viral | Conjunctival injection with watery or mucoserous discharge; other viral symptoms may be present (eg, URI symptoms) |
Bacterial | Redness and purulent discharge In neonates, this condition is called ophthalmia neonatorum and is usually caused by gonococcal or chlamydial infection |
Allergic | Redness, watery discharge, and itching; other allergic symptoms may be present (eg, rhinitis) |
Mechanical | History of trauma |
Toxic | History of ocular exposure |
Conjunctival foreign body | Photophobia, erythema, history of trauma; foreign body may be viewed directly or with slit lamp |
Glaucoma | Photophobia; corneal clouding; increased corneal diameter; increased IOP |
Uveitis | Photophobia, pain, ciliary injection; may occur after trauma or with certain inflammatory conditions (eg, SLE, Kawasaki disease) |
Corneal abnormalities | |
Corneal abrasion | Photophobia, erythema, history of trauma; positive fluorescein examination |
Corneal foreign body | Photophobia, erythema, history of trauma; foreign body may be viewed directly or with slit lamp |
Corneal ulcer | Conjunctival injection, chemosis, corneal opacity, photophobia, pain, tearing and discharge Corneal ulcers can be caused by bacteria, fungal infection, acanthamoeba, herpes simplex virus, varicella, or other viruses |
Lid abnormalities | |
Trichiasis (ingrown eyelashes) | May be caused by entropion (in-turning of the eyelid) or epiblepharon (extra fold of skin along the lower lid margin) |
Blepharitis (inflammation of the eyelids) | Crusting or matting of eyelashes; itching; burning; redness |
Post-traumatic lid and orbit abnormalities | History of facial trauma |
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